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Individual

NICHOLAS PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
845 SW 30TH ST, CORVALLIS, OR 97331-8629
(541) 768-7700
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD169780
OR
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
MD169780
OR

Other

Enumeration date
06/11/2010
Last updated
01/14/2021
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